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EP4385430A1 - Dispositif de maintien pour un dispositif de lithotripsie et dispositif de lithotripsie destiné à la destruction de calculs corporels - Google Patents

Dispositif de maintien pour un dispositif de lithotripsie et dispositif de lithotripsie destiné à la destruction de calculs corporels Download PDF

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Publication number
EP4385430A1
EP4385430A1 EP23217016.7A EP23217016A EP4385430A1 EP 4385430 A1 EP4385430 A1 EP 4385430A1 EP 23217016 A EP23217016 A EP 23217016A EP 4385430 A1 EP4385430 A1 EP 4385430A1
Authority
EP
European Patent Office
Prior art keywords
holding device
distal
proximal
housing
vibration
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP23217016.7A
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German (de)
English (en)
Other versions
EP4385430B1 (fr
Inventor
Bernhard Glöggler
Beat Krattiger
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Karl Storz SE and Co KG
Original Assignee
Karl Storz SE and Co KG
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Filing date
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Application filed by Karl Storz SE and Co KG filed Critical Karl Storz SE and Co KG
Publication of EP4385430A1 publication Critical patent/EP4385430A1/fr
Application granted granted Critical
Publication of EP4385430B1 publication Critical patent/EP4385430B1/fr
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    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B06—GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS IN GENERAL
    • B06B—METHODS OR APPARATUS FOR GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS OF INFRASONIC, SONIC, OR ULTRASONIC FREQUENCY, e.g. FOR PERFORMING MECHANICAL WORK IN GENERAL
    • B06B1/00—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency
    • B06B1/02—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy
    • B06B1/06—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction
    • B06B1/0607—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction using multiple elements
    • B06B1/0611—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction using multiple elements in a pile
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00106—Sensing or detecting at the treatment site ultrasonic
    • A61B2017/0011—Sensing or detecting at the treatment site ultrasonic piezoelectric
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22005—Effects, e.g. on tissue
    • A61B2017/22011—Combined types of vibration, e.g. ultrasonic and electrohydraulic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22014—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22014—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
    • A61B2017/22015—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22025—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement applying a shock wave
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22027—Features of transducers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320088—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with acoustic insulation, e.g. elements for damping vibrations between horn and surrounding sheath
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B06—GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS IN GENERAL
    • B06B—METHODS OR APPARATUS FOR GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS OF INFRASONIC, SONIC, OR ULTRASONIC FREQUENCY, e.g. FOR PERFORMING MECHANICAL WORK IN GENERAL
    • B06B1/00—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency
    • B06B1/02—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy
    • B06B1/06—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction
    • B06B1/0644—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction using a single piezoelectric element
    • B06B1/0651—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction using a single piezoelectric element of circular shape
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B06—GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS IN GENERAL
    • B06B—METHODS OR APPARATUS FOR GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS OF INFRASONIC, SONIC, OR ULTRASONIC FREQUENCY, e.g. FOR PERFORMING MECHANICAL WORK IN GENERAL
    • B06B2201/00—Indexing scheme associated with B06B1/0207 for details covered by B06B1/0207 but not provided for in any of its subgroups
    • B06B2201/70—Specific application
    • B06B2201/76—Medical, dental

Definitions

  • the invention relates to a holding device for a lithotripsy device for breaking up body stones, wherein the holding device has a housing with a distal end and a proximal end and a sonotrode can be connected to the distal end, wherein an acceleration tube with a longitudinal central axis, a cavity, a proximal end, a distal end and with a movable projectile within the cavity for shock excitation of the sonotrode, a proximal-side stop element at the proximal end and a distal-side stop element at the distal end of the acceleration tube are arranged in the housing, and a force generating device for generating a force for moving the projectile back and forth between the proximal-side stop element and the distal-side stop element can be assigned to the holding device, and a vibration excitation device for vibration excitation of the sonotrode is arranged in the housing. Furthermore, the invention relates to a lithotripsy device, in particular an intracorporeal lithotri
  • Lithotripsy is a well-known procedure for breaking up body stones, which form as so-called concretions in body organs such as the bladder or kidneys, for example through condensation and/or crystallization of salts and proteins.
  • the body stones are too large to pass naturally and cause discomfort, they must be broken up using a lithotripter so that the broken up stones can be removed through natural excretion and/or using a suction-irrigation pump.
  • the body stones to be broken up are often inhomogeneous with different components and/or strengths.
  • combination systems are used, particularly in intracorporeal lithotripsy, which use two different excitation and/or vibration sources in combination.
  • intermittent, ballistic shock wave energy is often added. This can be done, for example, using a ballistic drive with electromagnets, in which an impact body is accelerated by the electromagnets and hits a horn and/or the sonotrode head.
  • the disadvantage here is that due to the heating of the electromagnets during continuous operation, at least the distal end of the handle of such a lithotripter must be actively cooled.
  • the instrument is heavy and ergonomically awkward due to the permanently connected hybrid cable required for cooling.
  • the projectile In ballistic systems with a purely pneumatic drive or combination systems with a pneumatic unit, the projectile is moved in an acceleration tube in a distal direction and must be moved back in a proximal direction after a blow to the probe or sonotrode.
  • an air reservoir with a valve can be arranged on the distal side or, as in the DE 20 2014 007 692 U1 As described, a storage chamber is arranged around the acceleration tube.
  • the disadvantage of both resetting variants is that the installation space in the pneumatic unit and/or lithotripsy device is limited due to the air reservoir or the storage chamber and the installation of other components, such as flushing and suction lines, is structurally difficult.
  • an ultrasonic vibration compensator in ultrasonic transducers on the opposite side of the horn and thus at the vibrating proximal end of the ultrasonic converter, which serves as a mechanical fastening element between a stationary housing of the lithotripsy device and the vibrating, proximal end of the ultrasonic converter. If this ultrasonic vibration compensator is designed specifically, it reduces the ultrasonic vibrations along its length to a minimum or zero without noticeably detuning the ultrasonic converter in its resonance frequency.
  • the dimensions of such an ultrasonic vibration compensator cannot be designed arbitrarily, since otherwise an undesirable detuning of the ultrasonic converter occurs, undesirable transverse vibrations are stimulated and/or unpleasant noises can occur.
  • the housing length in the proximal direction cannot be freely designed.
  • the object of the invention is to improve the state of the art.
  • a holding device for a lithotripsy device for breaking up body stones wherein the holding device has a housing with a distal end and a proximal end and a sonotrode can be connected to the distal end, wherein an acceleration tube with a longitudinal central axis, a cavity, a proximal end, a distal end and with a movable projectile within the cavity for shock excitation of the sonotrode, a proximal-side stop element at the proximal end and a distal-side stop element at the distal end of the acceleration tube are arranged in the housing, and a force generating device for generating a force for moving the projectile back and forth between the proximal-side stop element and the distal-side stop element can be assigned to the holding device, and a vibration excitation device for vibration excitation of the sonotrode is arranged in the housing, wherein the holding device has a vibration compensation device with at least one mass and at least one Spring element, so that by means of
  • a handpiece for a lithotripsy device with a combined impact and vibration excitation and a vibration compensation device for compensating ultrasonic vibrations is provided. Consequently, undesired excited vibrations generated by the vibration excitation device on the acceleration tube are prevented or at least reduced, whereby the vibration excitation device and the ballistic drive by means of the force generation device are independent are adjustable and operable independently of one another.
  • the holding device for a combined lithotripsy device is lightweight due to the multifunctional vibration compensation device, does not need to be cooled and has an impact excitation that can be switched on and adjusted as required.
  • the resting and thus stationary acceleration tube is thus securely held in the housing of the holding device and at the same time reliably decoupled from the strong ultrasonic vibrations at the distal end of the ultrasonic converter by means of the vibration compensation device.
  • the vibration compensation device has at least one mass as its own and independent rest mass, the vibration compensation device and the housing can be designed independently of each other.
  • the vibration compensation device is precisely tuned for the respective ultrasonic vibrations, for example with a frequency of around 27 kHz, and because the vibration compensation device can be freely designed, it has a ⁇ /4 geometry that corresponds to the resonance frequency of the ultrasonic converter and therefore does not or hardly detune it.
  • a lightweight holding device is provided as a handpiece of a combined lithotripsy device with optimally usable installation space, which is structurally simple and cost-effective to manufacture.
  • An essential idea of the invention is to ensure a free design of this vibration compensation device independently of the design of the housing within the holding device by means of a vibration compensation device with at least one spring element and with at least one mass as its own, integrated rest mass and thereby, in addition to the vibration decoupling of the acceleration tube of the ballistic impact excitation, to simultaneously provide further advantageous functions for a combined lithotripsy device by means of the vibration compensation device and to efficiently utilize a compact installation space within the holding device.
  • a “lithotripsy device” (also called a “lithotripter”) is in particular a device for breaking up body stones by means of impacts, shock waves and/or deformation waves.
  • a lithotripsy device is understood to mean in particular various components, structural and/or functional components of a lithotripter.
  • the A lithotripsy device can completely or partially form a lithotripter.
  • a lithotripsy device can in particular be an intracorporeal or extracorporeal lithotripsy device. In the case of an intracorporeal lithotripsy device, this can additionally have a flushing/suction pump.
  • the lithotripsy device can be designed as a hand-held device and/or have an endoscope or be inserted into an endoscope.
  • the lithotripsy device is in particular autoclavable and comprises, for example, instrument steel and/or plastic.
  • the lithotripsy device can have further components, such as a control and/or supply device, or these are assigned to the lithotripsy device.
  • a lithotripsy device is in particular a combined lithotripsy device with a ballistic and/or pneumatic unit and assignable force generation device and a vibration excitation device.
  • a specifically shaped deformation wave is impressed directly or indirectly on the sonotrode in particular by means of impact energy when a projectile strikes a distal-side stop element.
  • the deformation wave in particular causes a translational movement of the sonotrode, which causes stone fragmentation due to the deflection.
  • the sonotrode in addition to the mechanical impact, is also excited to oscillate, in particular longitudinal oscillation and/or transverse oscillation, in particular by means of an oscillation excitation device, for example with an ultrasound transducer.
  • the sonotrode is thus designed in particular as a waveguide for the oscillation waves generated by the oscillation excitation device and for the deformation waves of the projectile.
  • a “holding device” (also called a "handpiece”) is in particular a hand and/or holding part of the lithotripsy device.
  • the holding device can in particular be a handle for manual and/or automated operation and/or connection of the lithotripsy device.
  • a holding device can also be arranged, connected and/or guided automatically at a distal end of a robot arm.
  • the holding device in particular has a housing.
  • the holding device can also be designed in two or more parts.
  • the holding device can have a separate housing for a pneumatic unit and a separate housing for the vibration excitation device.
  • distal and distal are understood to mean an arrangement close to the patient's body and thus far from the user and/or a corresponding end or section. Accordingly, the terms “proximal” and “proximal” are understood to mean an arrangement close to the user and thus far from the patient's body or a corresponding end or section.
  • a "sonotrode” is in particular a component which is itself set into vibration and/or resonance vibration by the action and/or introduction of mechanical vibrations.
  • the sonotrode is designed in particular as a waveguide for the vibration waves generated by the vibration excitation device and for the deformation waves by the impact of the projectile accelerated by the force generation device.
  • the sonotrode is in particular directly or indirectly connected to the vibration excitation device, the ultrasound transducer and/or the horn.
  • the sonotrode is screwed into the distal end of the horn.
  • the sonotrode has in particular at its proximal end a sonotrode head for receiving, transmitting and/or focusing ultrasound waves and at its distal end a sonotrode tip for directly and/or indirectly applying and/or contacting body stones.
  • the sonotrode is in particular shaped in such a way that it optimally introduces the vibration waves, the ultrasonic vibration and/or the deformation waves at its distal end into the body, the body region to be treated and/or directly onto the body stone to be broken up.
  • the sonotrode works in particular in the ultrasound range with a frequency range of 20 kHz to 90 kHz, preferably from 20 kHz to 34 kHz.
  • the sonotrode in particular comprises steel, titanium, aluminum and/or carbon.
  • a sonotrode is in particular a probe which is, for example, rod-, tube- and/or hose-shaped.
  • the sonotrode can be designed in one piece or in multiple parts.
  • the sonotrode in particular has a diameter in a range of 0.5 mm to 4.5 mm, in particular from 0.8 mm to 3.8 mm.
  • an “acceleration tube” is in particular an elongated hollow body whose length is larger than its diameter.
  • the acceleration tube has in particular a hollow space in its interior in which a projectile can move freely in the longitudinal direction. Furthermore, the acceleration tube has in particular a proximal end and a distal end, which spatially, after deducting the projectile length, approximately define the maximum acceleration distance.
  • the acceleration tube is surrounded on the distal side and/or at its distal end section, in particular at least partially by the horn and a bolt connected to or associated with the horn.
  • the acceleration tube has at least one opening for the inlet and/or outlet of a pressure medium, in particular compressed air.
  • the acceleration tube is made of a metal in particular.
  • a "stop element” is in particular a desired end point of the movement of the projectile along the acceleration path within the cavity of the acceleration tube, at which the accelerated projectile strikes the stop element, is braked and/or moved in the opposite direction.
  • a distal-side stop element is arranged in particular on and/or in the distal end of the acceleration tube and/or within the cavity in an area of the distal section of the acceleration tube. The distal-side stop element transfers the impact of the projectile to the sonotrode, in particular directly or indirectly.
  • the distal-side stop element can be, for example, a proximal-side wall of the horn, a spring element or a proximal-side wall of a holder of a spring element.
  • the proximal-side stop element is arranged in particular on and/or in the proximal end of the acceleration tube or within the cavity in a proximal section of the acceleration tube.
  • the proximal stop element can, for example, be a wall of the housing and/or a spring element.
  • a "projectile” is in particular a body that can move freely along the acceleration path within the cavity of the acceleration tube.
  • the projectile can move back and forth in particular between the proximal stop element and the distal stop element within the cavity of the acceleration tube arranged therebetween.
  • the projectile can have any shape.
  • the projectile can have the shape of a bolt or a ball.
  • the projectile in particular has hard steel and/or weakly magnetic properties.
  • the projectile in particular has a slightly smaller outer diameter than the diameter of the cavity of the acceleration tube.
  • the projectile can have an outer diameter of 8 mm, in particular 6 mm, or 4 mm.
  • a "force generating device” can in principle be any type of device that exerts a force on the projectile and thus causes the projectile to move.
  • the force generating device can, for example, be a device that accelerates the projectile using a laser, a pressure medium, for example pneumatically using compressed air, an electromagnetic field and/or a mechanical device.
  • a pneumatic force generating device can, in particular, cause a linear movement of the projectile in the cavity of the acceleration tube by supplying and/or removing a pressure medium.
  • the pressure medium flows in particular through at least one proximal opening of the acceleration tube into the cavity of the acceleration tube and presses and accelerates the projectile in the distal direction.
  • a “vibration excitation device” is in particular any device for generating vibrations in the ultrasound range.
  • the vibration excitation device has in particular an ultrasound transducer (also called an ultrasound converter) which converts a supplied alternating voltage with a certain frequency into a mechanical vibration frequency, or the vibration excitation device is formed by the ultrasound transducer.
  • the ultrasound transducer is in particular an electromechanical transducer using the piezoelectric effect. By applying the electrical alternating voltage generated by an ultrasound generator, a mechanical vibration is generated due to a deformation of the ultrasound transducer.
  • the ultrasound transducer has in particular a piezo element or several, preferably stacked, piezo elements.
  • the ultrasound transducer preferably has at least two piezo elements, with an electrical conductor, for example a copper disk, being arranged between the piezo elements.
  • a distal-side piezo element of the ultrasound transducer lies in particular directly against a proximal wall of a horn.
  • a counter bearing is arranged in particular on the proximal side of the piezo element or the piezo elements.
  • An intermediate disk can be arranged between the proximal end of the proximal-side piezo element and the distal end of the counter bearing.
  • the piezo element, the piezo elements, the intermediate disk and/or the counter bearing can in particular be arranged around a bolt, in particular a hollow bolt, which is arranged on the proximal side of the horn.
  • the horn ends with a wall opposite to the transmission direction, in particular on the proximal side.
  • a bolt is arranged in particular on the proximal side of this wall.
  • the bolt is preferably a hollow bolt.
  • the horn and the bolt can in particular be designed as two separate components.
  • the horn and the bolt are preferably a one-piece component, with a horn section corresponding to the conventional horn and, in particular in the proximal direction, merging in a stepped manner into the hollow bolt section with a smaller cross-section.
  • At least one piezo element with electrical contact and the counter bearing and/or an additional intermediate disk arranged between the proximal-side piezo element and the distal side of the counter bearing are arranged around the hollow bolt section.
  • the counter bearing is in particular screwed onto the hollow bolt or the hollow bolt section and thereby clamps at least one piezo element and/or the intermediate disk.
  • the counter bearing can be designed as a screw nut.
  • a proximal end section of the hollow bolt section and/or the hollow bolt protrudes in particular in the proximal direction beyond the proximal end of the counter bearing.
  • a connecting section of the vibration compensation device is arranged and/or connected surrounding this protruding proximal end section of the hollow bolt section and/or hollow bolt.
  • the connecting section of the vibration compensation device is screwed onto the proximal section of the hollow bolt section and/or hollow bolt and thus mechanically coupled to it.
  • the proximal end of the ultrasonic transducer is mechanically coupled to the connecting section of the vibration compensation device.
  • a “vibration compensation device” (also called an “amplitude compensator”) is in particular a component or assembly which has at least one mass and at least one spring element.
  • the vibration compensation device serves in particular for the vibration-technical decoupling of the acceleration tube of the ballistic and/or pneumatic drive from the vibration excitation by means of the vibration excitation device.
  • the spring element is arranged in particular on the distal side and the mass as a rest mass on the proximal side of the vibration compensation device.
  • the vibration compensation device in particular has a continuous cavity in its mass and its spring element through which the acceleration tube so that the acceleration tube is surrounded by the vibration compensation device on its outer surface.
  • the vibration compensation device has, as further components, in particular at least one connecting element for connecting the mass and at least one sealing element, such as an O-ring.
  • the sealing element simultaneously acts as a damping element.
  • the vibration compensation device can also have several spring elements, for example arranged parallel to one another, and/or several masses.
  • a "spring element” is in particular a component and/or a section of the vibration compensation device that can be deformed sufficiently elastically.
  • the spring element in particular comprises metal and/or plastic.
  • a spring element can in particular be a conventional spring, such as a coil spring and thus a wire wound in a helical shape.
  • the spring element is preferably a thin-walled tube section, which acts in particular as a ⁇ /4 mass spring element.
  • the mass and/or the entire vibration compensation device in particular comprises aluminum and/or steel.
  • the entire amplitude compensator preferably comprises aluminum and/or an aluminum alloy. While the spring element of the vibration compensation device oscillates during operation and thus has a damping effect, the mass remains at rest and does not oscillate due to its significantly greater weight.
  • a " ⁇ /4 geometry" of the vibration compensation device is understood to mean in particular that when the ultrasonic transducer is attached to an amplitude antinode (antinode), the spring element of the vibration compensation device has a distance of ⁇ /4 from the proximal mass of the vibration compensation device, i.e. from its corresponding amplitude node.
  • the maximum amplitude is present at the distal end of the spring element, which is dampened proximally by the spring element due to the elastic properties, so that in the proximal mass of the vibration compensation device only a There is little or no residual ultrasound amplitude, which results in vibrational decoupling from the stationary acceleration tube. Because the vibration compensation device has a ⁇ /4 geometry, this corresponds to the resonance frequency of the ultrasonic transducer and does not detune the ultrasonic transducer or does so only very slightly.
  • a "longitudinal central axis" is in particular the axis of the respective body or component which corresponds to the direction of its greatest extension and/or dimension.
  • the longitudinal central axis can also be the axis of symmetry of the respective body and/or component.
  • a "longitudinal direction” is in particular the direction of the longest extension of a component and/or body.
  • the longitudinal direction is in particular the direction along the longitudinal center axis of the mass, the sonotrode and/or the acceleration tube.
  • the mass is arranged free from a connection to the housing in its longitudinal direction and/or at its proximal end.
  • the acceleration tube can be optimally installed in the housing, even if this usually has to have a certain length for efficient function.
  • the housing of the holding device can be extended as desired, in particular in the proximal direction, without changing the ultrasound conditions of the vibration excitation device.
  • the mass is connected directly or indirectly to the housing essentially transversely to its longitudinal direction by means of at least one connecting element.
  • transverse moments on the ultrasonic converter which is elastically and movably mounted at the node of the horn, are absorbed by the vibration compensation device and are specifically diverted essentially in a direction transverse to the longitudinal direction of the mass and/or the acceleration tube.
  • the amplitude compensator can thus be screwed to the vibrating proximal end of the ultrasonic transducer and/or the hollow bolt, while the thicker opposite component end of the amplitude compensator is connected as a rest mass via its outer surface directly or indirectly to the housing by means of at least one connecting element and is thus mounted.
  • connection between the mass of the amplitude compensator and its longitudinal direction does not necessarily have to have an angle of 90°.
  • the longitudinal axis of the connecting element can also have an angle smaller than 90° to the longitudinal direction of the mass and/or the acceleration tube, for example this angle can be 60°.
  • the fastening of the mass of the amplitude compensator by means of at least one connecting element makes the ultrasonic transducer more stable and connects it to the housing, thus allowing larger forces and moments to be transmitted.
  • the mass is connected directly or indirectly to the housing by means of at least three radially evenly spaced connecting elements.
  • the mass of the amplitude compensator is mounted radially on the surrounding housing by means of at least three evenly distributed connecting elements and the vibrations and/or forces are distributed evenly or unevenly over the surface of the mass radially into the housing, depending on the moment.
  • the at least one connecting element or the at least three radially evenly spaced connecting elements and, if necessary, an additional sealing element, such as an O-ring as a damping element, are arranged in and/or on the mass as a rest mass, they move due to the low residual ultrasound amplitude negligible and consequently abrasion, loss and/or heating of the at least one connecting element, the connecting elements and/or a sealing element is very low and/or negligible.
  • a point connection is formed directly or indirectly with the housing by means of at least one connecting element or elements.
  • the point connection or point connections absorb transverse moments that would otherwise cause the proximal end of the ultrasound converter to collide with the housing wall, which could lead to noise, malfunctions and damage in addition to functional impairments. Furthermore, without this moment transfer by means of the point connection of the respective connecting element with the housing or indirectly via another component with the housing, the soft, flexible housing bearing would cause a wobbly, imprecise and therefore disadvantageous feeling for the user when handling the holding device and/or lithotripsy device.
  • the point bearing of the mass of the amplitude compensator also prevents detuning of the ultrasound converter and excessive loss of vibration power in the housing.
  • the at least one connecting element or the connecting elements comprise plastic.
  • the at least one connecting element or the connecting elements comprise plastic and thus a plastic surface is present at the connection in contact with the housing or indirectly with the component of the housing, residual ultrasonic amplitudes do not lead to metallic rattling. Consequently, the housing or a component in the housing against which the connecting element or the connecting elements rest may comprise metal.
  • a "connecting element” is in particular an element that creates a mechanical connection between the mass of the vibration compensation device and the housing or a component in the housing.
  • the connecting element can in particular create a positive and/or non-positive connection.
  • the mass can also be loosely connected and guided with some play by the connecting element or the connecting elements on and/or in a component in the housing or the housing.
  • the connecting element is, for example, a pin or bolt.
  • the connecting element preferably comprises plastic. In order to produce a point connection and thus a connection only at one point or a small area of the connecting element, the connecting element can be specially shaped.
  • the connecting element can have, for example, a tip or a locking lug, which engages, for example, in a recess or a corrugation in the housing or in a component within the housing.
  • each connecting element preferably has a specially shaped small-area bearing point made of plastic.
  • the plastic material of the connecting element simultaneously provides additional damping.
  • the connecting element can also be a bolt which has plastic and a spherical contact surface. The spherical geometry or a spherical or semicircular end of the connecting element optimally aligns the transverse moments to a contact point and diverts them via this.
  • the at least one spring element is designed as a tube section, with a wall thickness of the tube section being smaller than a material thickness of the mass.
  • the pipe section has significantly thinner walls than the material thickness of the mass of the vibration compensation device, the pipe section acts directly as a ⁇ /4 mass spring element. It is particularly advantageous that the amplitude compensator can be manufactured as a one-piece component with the distal pipe section and the proximal mass.
  • the “material thickness” of the mass is in particular the material thickness of the mass from its outer surface to its inner surface adjacent to the acceleration tube.
  • the “wall thickness” is in particular the thickness of the tube of the tube section.
  • the vibration compensation device has a cavity and/or a recess for receiving a pressure medium and optionally at least one sealing element.
  • This provides a further function of the vibration compensation device in that a reservoir or a chamber is provided by means of the recess and/or a cavity in the vibration compensation device, in which, in the case of a pneumatic force generating device, the pressure medium is compressed when the projectile moves in the distal direction and, after the projectile has struck the distal-side stop element, the compressed pressure medium can be used to move the projectile back in the opposite, proximal direction.
  • a compressed air spring for resetting the projectile can be implemented by using the compressed pressure medium, in particular compressed air, to build up counterpressure in the recess and/or the cavity of the vibration compensator, so that when the pneumatic valve is switched off under venting conditions, the projectile can be reliably moved back to its starting position using the compressed compressed air.
  • the amplitude compensator is therefore a combination component that provides both vibration decoupling and an internal volume to accommodate the compressed pressure medium.
  • the cavity and/or the recess of the vibration compensation device are adjusted accordingly in terms of their size and thus the accommodation volume in order to prevent the counterpressure that builds up as a compressed air spring from weakening the impact of the projectile too much if the volume is too small, so that the shattering power decreases.
  • the cavity and/or the recess can be arranged freely in the vibration compensation device.
  • the cavity and/or the recess is at least partially formed in the pipe section.
  • this is, for example, introduced into the inner wall of the pipe section, so that the volume for receiving the pressure medium is arranged between the inner wall of the pipe section at the recess and the outer surface of the acceleration tube.
  • This volume is in particular in a range from 3 ml to 16 ml, preferably from 5 ml to 11 ml.
  • the volume for receiving the pressure medium can be in particular 7.6 ml.
  • the usable volume (air reservoir) for compressed air formed by means of the cavity and/or the recess is designed in particular for a high projectile frequency and/or impact frequency.
  • this volume is sealed by means of a sealing element, for example an O-ring, or several sealing elements.
  • the acceleration tube and/or the recess is sealed as a compressed air chamber to the interior of the housing around the ultrasonic transducer.
  • This air reservoir for resetting the projectile is preferably sealed with a proximal sealing element relative to the acceleration tube and with a distal sealing element between the connecting section of the amplitude compensator and the hollow bolt section and/or hollow bolt on the proximal side of the horn, whereby the compressed air cannot flow into the interior of the housing. Since the tube section is not sealed to the acceleration tube on the distal side, the compressed air can flow through a compressed air channel between the inner surface of the tube section, the hollow bolt section and the horn and the outer surface of the acceleration tube between the air reservoir and the distal end of the acceleration tube in a proximal direction or in a distal direction.
  • the proximal sealing element also prevents rattling, as it prevents metallic contact between the acceleration tube and the resting mass of the amplitude compensator, which is subject to residual amplitude.
  • the distal and proximal sealing elements of the amplitude compensator also absorb vibrations.
  • the vibration compensation device is arranged at least partially around the acceleration tube.
  • the vibration compensation device is arranged concentrically around the acceleration tube.
  • the holding device has a circuit board holder, wherein the circuit board holder is arranged at least partially around the vibration compensation device and the mass of the vibration compensation device is connected to the circuit board holder by means of the at least one connecting element.
  • the circuit board holder has the dual function of being a carrier element for electronic components within the holding device as well as a bearing for the mass of the amplitude compensator and thus as an indirect connecting component for the bearing of the mass by means of one or more connecting elements.
  • the holding device has a horn on the distal side and a bolt on the proximal side of the horn, wherein the horn and the bolt surround a distal section of the acceleration tube, a counter bearing is arranged on the bolt on the proximal side of the horn and at least one piezo element is arranged between the counter bearing and the horn as a vibration exciter and is mechanically coupled, wherein the horn has the distal-side stop element and/or the horn can be connected to the distal-side stop element and/or sonotrode and the at least one Piezo element is electrically connectable to an assignable ultrasonic generator, wherein the vibration compensation device is arranged on the proximal side on and/or of the horn, the bolt and/or the counter bearing.
  • the at least one spring element has a connecting portion, wherein the connecting portion surrounds a proximal end portion of the bolt and/or is arranged proximally from the counter bearing.
  • the mass has an opening and/or at least one recess on its outer surface in its longitudinal direction for guiding a line and/or a hose.
  • the recess or a breakthrough through the mass in the longitudinal direction provides sufficient space for the passage of hoses and/or electrical cables, for example the electrical cables from the electrical contacts of the piezo elements to the proximal cable feedthrough and/or the socket at the proximal end of the housing.
  • the recess can, for example, be a milled out section in the outer surface and thus in the lateral surface of the mass continuously in the longitudinal direction.
  • three evenly spaced semicircular milled out sections with a large radius can be made in the outer surface of the mass.
  • It can also be a longitudinal breakthrough in an outer material area of the mass, for example appropriately spaced elongated holes distributed over the cross-section of the mass.
  • the object is achieved by a lithotripsy device, in particular an intracorporeal lithotripsy device, for breaking up body stones, wherein the lithotripsy device has a sonotrode and a holding device, and the holding device is a holding device as described above.
  • a lithotripsy device is provided with a handpiece which is optimally designed due to the multifunctional amplitude compensator with regard to the efficient use of the installation space, the targeted handling by a user, the freely adjustable length of the housing and the independent adjustability of the ballistic and/or pneumatic shock excitation and the ultrasonic excitation due to the vibration decoupling.
  • a lithotripsy device 101 has a handpiece 103 with a housing 104. At its proximal end, the housing 104 is closed with a cover 131. On the proximal side of the cover 131, an electrical connection 135 and a connecting piece 137 for supplying compressed air are arranged. On the distal side, the housing 104 has a sleeve 129 which surrounds a horn 127. A sonotrode 121 is screwed into the horn 127 at its proximal end 123 by means of its sonotrode head 119. A distal end 125 of the sonotrode opposite the proximal end 123 serves to break up body stones ( Figure 1 ).
  • the horn 127 has a tapered section in a distal direction 116. On the proximal side of this tapered section, the horn 127 merges into a hollow bolt 176 in one piece.
  • the horn 127 is mounted in the housing 104 at its largest cross-section by means of two O-rings 181.
  • An acceleration tube 105 is arranged inside the hollow horn 127 and the adjoining hollow bolt 176, which extends from its distal end 110 to its proximal end 109 along a longitudinal central axis 117 (see Figures 2 , 3 and 4 ).
  • the acceleration tube 105 has a cavity 107 inside, in which a projectile 111 is movably arranged.
  • the proximal end 109 of the acceleration tube 105 is held in a tube holder 133 inside the housing 104.
  • the cavity 107 of the acceleration tube is fluidically connected to the connecting piece 137.
  • the projectile 111 is movable along the longitudinal center axis 117 in the cavity 107 of the acceleration tube 105 between a proximal-side stop element 113 and a distal-side stop element 115.
  • the distal-side stop element 115 is formed by a proximal-side wall of the horn 127.
  • An ultrasonic transducer 171 is arranged around the hollow bolt 176 on the proximal side of the horn 127.
  • the ultrasonic transducer 171 has two piezo elements 173 with an electrical conductor and an electrical contact 174 arranged between them.
  • the piezo elements 173 are clamped between the horn 127 and an intermediate disk 175 by means of a proximal-side counter bearing 177, whereby the intermediate disk 175 and the counter bearing 177 also surround the hollow bolt 176.
  • the intermediate disk 175 has holes on its outer surface into which a hook wrench is placed when the piezo elements 173 are mounted on the hollow bolt 176 in order to divert a torque during assembly and to keep this away from the piezo elements 173, since otherwise there is a risk that the piezo elements 173 will twist and thus be damaged.
  • an amplitude compensator 141 is arranged around the acceleration tube 105.
  • the amplitude compensator 141 is made in one piece from aluminum and has a mass part 143 on the proximal side and a spring tube section 145 on the distal side.
  • the spring tube section 145 has a connecting section 147 at its distal end ( Figure 5 and 6 ).
  • the connecting section 147 is screwed onto the proximal end of the hollow bolt 176 and sealed by means of an internal distal O-ring 155.
  • the amplitude compensator 141 has a cavity inside through which the acceleration tube 105 is guided.
  • the amplitude compensator 141 has a recess 151 in its inner wall around the cavity, which recess 151 extends into the spring tube section 145 and a distal portion of the mass part 143, so that the amplitude compensator 141 has a compressed air reservoir 153 all around the acceleration tube 105 ( Figure 4 ).
  • the mass part 143 is sealed to the acceleration tube 105 with a proximal O-ring 157. Because the amplitude compensator 141 is only sealed with the proximal O-ring 157 on the proximal side of the acceleration tube 105, compressed air can flow into the compressed air reservoir 153 formed by the recess 151 on the distal side through a compressed air channel 187 between the outer surface of the acceleration tube 105 and the inner surface of the distal section of the amplitude compensator 141, the hollow bolt 176 and the horn 127 in the distal direction 117 from the compressed air reservoir 153 and flow into the cavity 107 through an opening 185 at the distal end 110 of the acceleration tube 105 and/or through the open end face at the distal end 110 of the acceleration tube 105.
  • compressed air from the cavity 107 can be pressed through the opening 185 and the open end face at the distal end 110 of the acceleration tube 105 into the compressed air channel 187 as an intermediate space between the outer surface of the acceleration tube 105 and the inner surface of the horn 127, the hollow bolt 176 of the distal section of the amplitude compensator 141 against the distal direction 116 into the compressed air reservoir 153 and collected there.
  • the distal O-ring 155 between the connecting section 147 of the spring tube section 145 and the proximal end of the hollow bolt 176 seals the compressed air channel 187 to the interior of the housing 104.
  • the spring tube section 145 of the amplitude compensator 141 has a significantly smaller wall thickness 161 in the area of the recess 151 than a material thickness 163 of the mass part 143 between the inner surface of a circuit board holder 183 and the outer surface of the acceleration tube 105. Due to the significantly smaller wall thickness 161 of 1 mm compared to the material thickness 163 of 27 mm of the mass part 143, the spring tube section 145 has elastic spring properties.
  • the circuit board holder 183 surrounds the acceleration tube 105 from its proximal end 109 in the distal direction 116 up to and including the amplitude compensator 141 and the counterholder 177.
  • the mass part 143 of the amplitude compensator 141 is guided on its outer surface by means of three radially evenly spaced plastic pins 159 at certain points on the inner surface of the circuit board holder 183 or is fastened in a force-locking and form-locking manner.
  • the circuit board holder 183 is in turn in radial circumferential contact with the inside of the housing 104, so that the amplitude compensator 141 is indirectly connected via the circuit board holder 183 is connected to the housing 104 in the radial direction.
  • the proximal end of the mass part 143 is just free from a connection to the housing 104 and the cover 131 in the proximal direction.
  • the mass part 143 has three partially circular through-passage recesses 149 which extend in the distal direction 116 for passing through electrical lines (not shown in the figures) from the electrical connection 135 to the ultrasonic transducer 171.
  • the following operations are carried out using the combined lithotripsy device 101 with a vibration excitation of the sonotrode 121 by means of the ultrasonic transducer 171 and a pneumatic drive for shock excitation of the sonotrode 121 by means of the projectile 111.
  • the ultrasonic transducer 171 is subjected to a voltage at the electrical contact 174, whereby a deformation of the piezo elements 173 within the ultrasonic transducer 171 takes place and an ultrasonic vibration is thereby indicated.
  • the ultrasonic vibration generated is introduced into the sonotrode 121 due to the conical section of the horn 127, whereby the sonotrode 121 is excited to an oscillation wave in a longitudinal oscillation as well as in the transverse direction.
  • compressed air is pressed through the connecting piece 137 into the cavity 107 at the proximal end 109 of the acceleration tube 105 by means of a force generating device (not shown), whereby the projectile 111 is propelled from the proximal end 109 as the initial state (see Figure 3 and 4 ) is moved in the distal direction 116 through the cavity 107 along the longitudinal central axis 117 from the proximal stop element 113 to the distal stop element 115 and by impacting on the distal stop element 115 via the distal end of the horn 127 and the sonotrode head 119 the impact of the projectile 111 is transmitted to the sonotrode 121.
  • the air in the distal section of the cavity 107 within the acceleration tube 105 is compressed and escapes through the opening 185 and the compressed air channel 187 between the outer surface of the acceleration tube 105 and the inner surface of the horn 127, the hollow bolt 176 and the distal section of the amplitude compensator 141 against the distal direction 116 into the compressed air reservoir 153 of the amplitude compensator 141, whereby the compressed air in the compressed air reservoir 153 is compressed.
  • the projectile 111 By impact of the projectile 111 against the distal-side stop element 115, the projectile 111 is repulsed and by simultaneously closing the incoming compressed air and venting through the connecting piece 137, the compressed air compressed in the compressed air reservoir 153 now flows in the distal direction 116 through the compressed air channel 187, the opening 185 and the open distal end face of the acceleration tube 105 into the cavity 107 and pushes the projectile 111 back to the proximal end 109 of the acceleration tube 105 until the initial state ( Figure 3 and 4 ) is reached again.
  • This impact excitation of the sonotrode 121 by the projectile 111 hitting the distal stop element 115 is repeated regularly.
  • the ultrasonic vibrations generated by the ultrasonic transducer 171 have a frequency of approximately 27 kHz, to which the amplitude compensator 141 is precisely tuned. Because the coupled amplitude compensator 141 has a ⁇ /4 geometry, which corresponds to the resonance frequency of the ultrasonic transducer 171, the amplitude of the vibration wave generated by the ultrasonic transducer 171 decays proximally along the spring tube section 145 continuously to virtually zero in the proximal mass part 143, and the ultrasonic transducer 171 is not or hardly detuned by the amplitude compensator 141. The mass part 143, as a rest mass, moves only negligibly, if at all, due to the low residual ultrasonic amplitude.
  • the radially circumferentially arranged plastic pins 159 for point-based mounting and the proximal O-ring 157 have an additional damping effect, so that abrasion, other damage and heating in the mass part 143 are negligible.
  • the proximal O-ring 157 of the amplitude compensator 141 also prevents rattling, since this prevents metallic contact between the acceleration tube 105 and the mass part 143 under residual amplitude as the rest mass.
  • the acceleration tube 105 has a length that is optimally adapted to the impact effect, so that the pneumatic drive of the projectile 111 in the acceleration tube 105 can be operated independently of the generated ultrasonic vibration by means of the ultrasonic transducer 171 and both drives can be adjusted independently of each other.
  • both the vibration excitation of the sonotrode 121 by means of the ultrasonic transducer 171 and the impact excitation of the projectile 111 can be used with an effective high fragmentation power.
  • the amplitude compensator 141 compensates for torques that can occur due to a flexible linear bearing of the horn 127 by means of the two O-rings 181 by means of the point-based mounting using the plastic pins 159 radially outward on the circuit board holder 183 and above that on the housing 104.
  • This absorption of possible transverse torques prevents the proximal end of the ultrasound transducer 171 from colliding with the inner wall of the housing 104 and consequently prevents corresponding noises, disturbances and/or damage.
  • the point-based mounting using the plastic pins 159 also enables the user of the combined lithotripsy device 101 to handle the housing 104 precisely and thus to guide the entire lithotripsy device 101 precisely.
  • the amplitude compensator 141 also provides the compressed air reservoir 153, the function of resetting the projectile 111 is simultaneously integrated in the amplitude compensator 141, which enables rapid resetting of the projectile 111 and thus a high impact frequency in a small installation space. Above all, an additional compressed air inlet distal to the projectile 111 and a corresponding valve switch for projectile resetting, which are complex and require a large construction, are not necessary.
  • a combined lithotripsy device 101 is provided with a multifunctional amplitude compensator 141, which decouples the acceleration tube 105 from the strong ultrasonic vibration of the ultrasonic transducer 171, provides a compressed air reservoir 153 for resetting the projectile 111, absorbs transverse moments and diverts them radially outwards in a targeted manner by means of a point-based bearing by means of plastic pins 159, whereby a proximal length of the housing 104 can be designed freely and independently.
  • the invention relates to a holding device for a lithotripsy device for breaking up body stones, wherein the holding device has a housing with a distal end and a proximal end and a sonotrode can be connected to the distal end, wherein in the housing has an acceleration tube with a longitudinal central axis, a cavity, a proximal end, a distal end and with a movable projectile within the cavity for shock excitation of the sonotrode, a proximal-side stop element at the proximal end and a distal-side stop element at the distal end of the acceleration tube, and the holding device can be assigned a force generating device for generating a force for moving the projectile back and forth between the proximal-side stop element and the dis

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EP23217016.7A 2022-12-15 2023-12-15 Dispositif de maintien pour un dispositif de lithotripsie et dispositif de lithotripsie destiné à la destruction de calculs corporels Active EP4385430B1 (fr)

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5397293A (en) * 1992-11-25 1995-03-14 Misonix, Inc. Ultrasonic device with sheath and transverse motion damping
US20020010486A1 (en) * 2000-06-15 2002-01-24 Ferton Holding S.A. Device for removal of calculi
DE202014007692U1 (de) 2014-09-26 2016-01-08 Storz Medical Ag Gerät zur Behandlung des menschlichen oder tierischen Körpers mit mechanischen Stößen
US11357523B2 (en) * 2018-01-19 2022-06-14 Ferton Holding S.A. Device and method for the fragmentation of a calculus
DE102022109138A1 (de) * 2022-04-13 2023-10-19 Karl Storz Se & Co. Kg Lithotripsievorrichtung zum Zertrümmern von Körpersteinen mit einer Steuerhülse und Verfahren zum Beschleunigen eines Projektils einer Lithotripsievorrichtung

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19624446C1 (de) * 1996-06-19 1998-03-26 Ferton Holding Chirurgisches Instrument zum mechanischen Entfernen von Knochenzement, sowie Verfahren zum Erzeugen von Stoßwellen
DE202011101571U1 (de) * 2011-05-30 2012-09-05 Storz Medical Ag Schalldämpfungshülse zum Aufsetzen auf ein Druckwellengerät
DE102020134602B4 (de) * 2020-12-22 2023-11-23 Karl Storz Se & Co. Kg Lithotripsievorrichtung, Lithotripsiesystem und Verfahren zum Betreiben einer Lithotripsievorrichtung

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5397293A (en) * 1992-11-25 1995-03-14 Misonix, Inc. Ultrasonic device with sheath and transverse motion damping
US20020010486A1 (en) * 2000-06-15 2002-01-24 Ferton Holding S.A. Device for removal of calculi
DE202014007692U1 (de) 2014-09-26 2016-01-08 Storz Medical Ag Gerät zur Behandlung des menschlichen oder tierischen Körpers mit mechanischen Stößen
US11357523B2 (en) * 2018-01-19 2022-06-14 Ferton Holding S.A. Device and method for the fragmentation of a calculus
DE102022109138A1 (de) * 2022-04-13 2023-10-19 Karl Storz Se & Co. Kg Lithotripsievorrichtung zum Zertrümmern von Körpersteinen mit einer Steuerhülse und Verfahren zum Beschleunigen eines Projektils einer Lithotripsievorrichtung

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